Original Article

Pathophysiology and diagnosis of descending perineum syndrome in children

  • MICHAEL D. LEVIN

Pelviperineology 2018;37(2):52-56

The purpose of this study is to offer a safe, simple and accurate method for diagnosing descended perineum syndrome (DPS).

Methods:

194 patients aged from five days to 15 years were surveyed in the Belarusian Center of Pediatric Surgery. They were divided into two groups. In the 1st group were 65 patients without abnormalities of the anorectal area. In the 2nd group were 129 patients, including 66 children with functional constipation, 55 children with anorectal malformations (ARM) with visible fistulas that were examined before surgery, and 8 patients with ARM investigated after surgery. All patients underwent barium enema, which differed from the standard study by the presence of a radiopaque marker placed near the anus.

Results and Conclusion:

DPS is caused by damage to the muscles and ligaments of the pelvic floor. A method of assessing DPS is proposed on the basis of changes in the distance between the anorectal angle and the marker near the anus. Administering a barium enema with a minimum of radiographs dramatically reduces the dose of ionizing radiation compared with defecography and contributes to a more accurate assessment of DPS not only for adults, but also for children with chronic constipation, fecal incontinence and ARM, both before and after surgery, allowing assessment of the causes of complications.

Keywords: Barium enema,Chronic constipation,Descending perineum syndrome,Defecography,Fecal incontinence,Puborectalis muscle